www.symbiosisonline.org Symbiosis www.symbiosisonlinepublishing.com Case Report Clinical Research in Dermatology: Open Access Open Access Atypical Acrodermatitis Chronica Atrophicans Herxheimer Wollina U1*, Boldt S1, Heinig B2, Schönlebe J3 1Department of Dermatology and Allergology 2Center of Physical and Rehabilitative Medicine 3Institute of Pathology “Georg Schmorl”, Academic Teaching Hospital Dresden-Friedrichstadt, Dresden, Germany Received: December 14, 2015; Accepted: December 19, 2015; Published: December 23, 2015 *Corresponding author: Prof. Dr. U. Wollina, Department of Dermatology and Allergology, Academic Teaching Hospital Dresden-Friedrichstadt, Friedrichstrasse 41, 01067 Dresden, Germany. E-mail:
[email protected] Abstract Acrodermatitis Chronica Atrophicans Herxheimer (ACA) is Sensitivity and specificity of enzyme immuno assay and immune a tick-born disease due to infection by Borrelia afzelii, the major blot are 95% and 80-95% for ACA [4]. Polymerase chain reaction vector organism is Ixodes rhicinus. We report on a 48-year-old male (PCR) of skin biopsies was positive in up to 88% on fresh-frozen tissueCase butReport only in 44-52% using paraffin-embedded tissue [5]. symmetric plaques associated with hyperpigmented widely distributedpatient who lesions developed within extensive the tension livid-erythematous lines, and acrocyanosis. fibrosclerotic The of a skin biopsy and laboratory investigations with positive IgG and A 48-year-old male patient was referred to our hospital IgMdiagnosis immunoblots. of ACA has The been patient confirmed was treated by histopathologic by intravenous examination ceftriaxone because of large livid-erythematous fibrosclerotic plaques on resulting in partial remission of cutaneous and extracutaneous his trunk and extremities which developed within half a year. He symptoms. suffered from arterial hypertension and had a penicillin allergy.